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Date:

SB Cards Corporation
15F Security Bank Building
6776 Ayala Avenue, Makati City
Fax: 840-2463 / 815-3649
customercare@sbcards.com.ph

Gentlemen:

Subject: Disputed Transaction/s

Please refer to my statement of account dated ______________________.

Diners Club: ___________________________________
Security Bank MasterCard: ________________________
Other Products: _________________________________

Home Address: ____________________________________ Phone Number: ___________

____________________________________
Office Address: ____________________________________ Phone Number: ___________
____________________________________
Cell number: ____________________________________
Email address: ____________________________________

I am disputing the posted transaction/s listed below:

Posting Date Transaction Date Establishment Name

Amount

Reason/s for the dispute:

Unauthorized transaction
Credit/refund not processed
Services not rendered
Cancelled transaction
Payment by other means
a.) Cash
b.) Others: ___________________
Others: _______________________________

Incident Report: (Mandatory)

Further to my above claim, I confirm that I fully understand and acknowledge that
the disputed amount credited to
my credit card is temporary pending the final result of the
investigation. Should the transaction prove to be
legitimate, I agree that the disputed amount shall be billed to my credit card with
the corresponding charges and
invoice retrieval fee of Php400 each.

Very truly yours,

Signature over printed name

CMS-38-05/08